Systems and methods of stimulation and activation of fluids for use with instillation therapy

ABSTRACT

Systems and methods of stimulating or activating fluids for use in wound treatment systems.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/456,886, filed Mar. 13, 2017, which is a continuation of U.S. patentapplication Ser. No. 14/216,522, filed Mar. 17, 2014, now U.S. Pat. No.9,623,224, which claims priority to U.S. patent application Ser. No.13/477,741, filed May 22, 2012, now U.S. Pat. No. 8,708,981, whichclaims priority to U.S. Provisional Patent Application Ser. No.61/490,150, filed May 26, 2011, the entire contents of which areincorporated herein by reference.

BACKGROUND 1. Field of the Invention

The present invention relates generally to healing of wounds andwound-treatment therapies. More particularly, but not by way oflimitation, the present invention relates to fluid-instillation andnegative-pressure wound therapies.

2. Background Information

Clinical studies and practice have shown that providing therapeuticfluids, particularly in conjunction with reduced pressure, in proximityto a tissue site augments and accelerates the growth of new tissue atthe tissue site. The applications of this phenomenon are numerous, butapplication of reduced pressure has been particularly successful intreating wounds. This treatment (frequently referred to in the medicalcommunity as “negative pressure wound therapy,” “reduced pressuretherapy,” or “vacuum therapy”) provides a number of benefits, includingfaster healing and increased formulation of granulation tissue.Typically, reduced pressure is applied to tissue through a wound insert(e.g., a porous pad or other manifold device). The wound inserttypically contains cells or pores that are capable of distributingreduced pressure to the tissue and channeling fluids that are drawn fromthe tissue. The wound insert can be incorporated into a wound dressinghaving other components that facilitate treatment, such as, for example,a drape (e.g., adhesive surgical drape). Instillation fluids may bedelivered to the wound insert and held in place at the site of thewound, further improving the efficacy of treatment.

Wound treatment systems, including for example, instillation therapyunits such as the V.A.C. Ulta Therapy System, available from KineticConcepts, Inc., San Antonio, Tex. U.S.A. may be used to deliver fluidswith a more pronounced therapeutic benefit than saline, and indeed, mayexpand in complexity and capability to be able to deliver a plurality offluids for different purposes dependent upon wound conditions. It isbelieved that fluids will be able to be used to reduce infection, to aidwith debridement, to improve the dressings removability and to addressbiofilm buildup in the wound.

Certain systems offer fluids with molecules which are tailored andeffective to provide the benefits described the above, but often are notdesigned for use with a system which doses the fluid over time andexposes the fluid to tubing and other plastic components. For example,wound treatment fluids may contain an active molecule that reacts withvarious types of plastic and light (including, e.g., ultraviolet light),thus weakening the molecules effectiveness and making its practicaldelivery to the wound site more difficult.

It is therefore desirable in systems with molecules which may besusceptible to negative impacts of contact with certain materials orlight to protect them or render them immune to these range ofdeleterious effects until the system determines they should be active.

As described herein, it is possible to provide for control of thestimulation or activation of fluids used in wound treatment systems.

SUMMARY

Systems and methods of stimulating or activating fluids for use in woundtreatment systems are presented.

Certain embodiments include a wound treatment system comprising: a wounddressing; a fluid storage device comprising a fluid, where the fluidstorage device is in fluid communication with the wound dressing; and anenergy source configured to direct energy to the fluid and to activate atherapeutic property of the fluid. Particular embodiments furthercomprise a negative pressure source coupled to the wound dressing. Incertain embodiments, the fluid comprises molecules with a coating priorto exposure to the energy source. In particular embodiments, the energysource is configured to degrade the protective coating. In specificembodiments, the energy source is configured to activate a component ofthe fluid that degrades the protective coating.

In certain embodiments, the protective coating comprises a polymershell. In particular embodiments, the protective coating comprises abioabsorbable glass. In specific embodiments, the protective coatingcomprises a ceramic.

In particular embodiments, the energy source emits ultrasonic energy. Incertain embodiments, the energy source emits magnetic energy. Inspecific embodiments, the energy source emits radio frequency energy. Inparticular embodiments, the energy source emits ionizing radiationenergy. In certain embodiments, the energy source emits microwaveenergy. In certain embodiments, the energy source emits light energy. Inparticular embodiments, the energy source is configured to direct energyto the fluid proximal to the wound dressing.

Specific embodiments comprise a conduit in fluid communication with thefluid storage device and the wound dressing. In certain embodiments, theenergy source is configured to direct energy to the fluid in theconduit. Particular embodiments comprise a coupling member coupling theconduit to the wound dressing. In certain embodiments, the energy sourceis configured to direct energy to the coupling member. In specificembodiments, the therapeutic property includes an anti-biotic property.In certain embodiments, the therapeutic property includes an analgesicproperty. In particular embodiments, the therapeutic property aids withdebridement of tissue. In certain embodiments, the therapeutic propertyimproves the ability to remove the wound dressing from a wound. Inspecific embodiments, the therapeutic property reduces biofilm buildupin a wound.

Particular embodiments include a method of treating a wound, where themethod comprises: applying a wound dressing to a wound; transportingfluid to the wound dressing; and directing energy to the fluid andactivating a therapeutic property of the fluid. In certain embodiments,the energy is directed to the fluid proximal to the wound dressing.Specific embodiments also include applying a negative pressure to thewound dressing. Particular embodiments also include providing a fluidstorage device and a conduit in fluid communication with the wounddressing. In certain embodiments, the energy is directed to the fluidwhen the fluid is in the conduit. Particular embodiments also include acoupling member coupling the conduit to the wound dressing. In specificembodiments, the energy is directed to the fluid at the coupling member.In certain embodiments, the fluid comprises molecules having a coatingand an active agent, and directing energy to the fluid breaks down theprotective coating.

Particular embodiments include a wound treatment system comprising: awound dressing; a negative pressure source coupled to the wounddressing; a fluid storage device comprising a fluid with moleculeshaving a coating, wherein the fluid storage device is configured forfluid communication with the wound dressing; and an energy sourceconfigured to direct energy to the fluid and degrade the coating.

In specific embodiments, the energy source directs light energy to thefluid. In certain embodiments, the energy source directs ultrasonicenergy to the fluid. In certain embodiments, the energy source directsmagnetic energy to the fluid. In particular embodiments, the energysource directs radio frequency energy to the fluid. In certainembodiments, the energy source directs ionizing radiation energy to thefluid. In particular embodiments, a therapeutic property of the fluid isactivated when the coating is degraded.

Certain embodiments include a method of treating a wound, where themethod comprises: applying a wound dressing to a wound; transportingfluid to the wound dressing, where the fluid comprises molecules havinga coating; and directing energy to the fluid and degrading the coating.In specific embodiments, degrading the coating activates a therapeuticproperty of the fluid. In particular embodiments, the therapeuticproperty includes an anti-biotic property. In certain embodiments, thetherapeutic property includes an analgesic property. In particularembodiments, the therapeutic property aids with debridement of tissue.In certain embodiments, the therapeutic property improves the ability toremove the wound dressing from a wound. In particular embodiments, thetherapeutic property reduces biofilm buildup in a wound.

The following drawings illustrate by way of example and not limitation.For the sake of brevity and clarity, every feature of a given structureis not always labeled in every figure in which that structure appears.Identical reference numbers do not necessarily indicate an identicalstructure. Rather, the same reference number may be used to indicate asimilar feature or a feature with similar functionality, as maynon-identical reference numbers.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a schematic diagram of an embodiment of a woundtreatment system.

FIG. 2 illustrates a schematic view of the embodiment of FIG. 1.

DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

The term “coupled” is defined as connected, although not necessarilydirectly, and not necessarily mechanically; two items that are “coupled”may be integral with each other. The terms “a” and “an” are defined asone or more unless this disclosure explicitly requires otherwise. Theterms “substantially,” “approximately,” and “about” are defined aslargely but not necessarily wholly what is specified, as understood by aperson of ordinary skill in the art.

The terms “comprise” (and any form of comprise, such as “comprises” and“comprising”), “have” (and any form of have, such as “has” and“having”), “include” (and any form of include, such as “includes” and“including”) and “contain” (and any form of contain, such as “contains”and “containing”) are open-ended linking verbs. As a result, awound-treatment method that “comprises,” “has,” “includes” or “contains”one or more steps possesses those one or more steps, but is not limitedto possessing only those one or more steps. Likewise, a wound dressingthat “comprises,” “has,” “includes” or “contains” one or more elementspossesses those one or more elements, but is not limited to possessingonly those elements. For example, in a wound dressing that comprises oneof the present wound inserts and a drape, the wound dressing includesthe specified elements but is not limited to having only those elements.For example, such a wound dressing could also include a connection padconfigured to be coupled to a negative pressure wound therapy (NPWT)apparatus (e.g., including a vacuum source and/or a fluid source).

Further, a device or structure that is configured in a certain way isconfigured in at least that way, but it can also be configured in otherways than those specifically described.

Turning now to the figures, FIG. 1 depicts a schematic diagram of awound treatment system 100 comprising a wound dressing 110, a fluidstorage device 120, an energy source 130, and a negative pressure source140. An overview of the operation of wound treatment system 100 will beprovided initially, followed by a more detailed discussion of anexemplary embodiment.

In the exemplary embodiment shown in FIG. 1, fluid storage device 120 isin fluid communication with wound dressing 110 via a conduit 150. Inaddition, energy source 130 is coupled to a coupling member 160, whichis in turn coupled to wound dressing 110.

In this exemplary embodiment, fluid storage device 120 comprises a fluid170 with molecules 175 having a protective coating 176 around an activeagent 177. During operation, fluid 170 is transported from fluid storagedevice 120, through conduit 150 and coupling member 160 to wounddressing 110. In the embodiment shown, energy source 130 can beactivated to direct energy towards fluid 170 at coupling member 160. Theexposure of fluid 170 to energy emitted from energy source 130 candegrade or break down protective coating 176 and allow active agent 177to be exposed, thereby activating a therapeutic property of fluid 170.Negative pressure source 140 can then draw fluid 170 from wound dressing110 into a suitable storage container (not shown).

Referring now to FIG. 2, a more detailed view and discussion of woundtreatment system 100 is provided. In this embodiment, fluid storagedevice 120 and energy source 130 are housed in wound treatment apparatus180, along with a supply pump 126 and a control system 127. Aspreviously explained, fluid storage device comprises fluid 170 havingmolecules 175 with protective coating 176 around active agent 177. Inthis embodiment, control system 127 is used to control supply pump 126,which pumps fluid 170 to wound dressing 110. It is understood that inother exemplary embodiments, negative pressure source 140 may be used todraw fluid from fluid storage device 120 without the use of supply pump126.

In this embodiment wound dressing 110 comprises a wound insert 112,which is shown placed in wound 116 of a patient (not shown). A drape 114is placed over wound 116 and wound insert 112 such that wound insert 112is between drape 114 and wound 116. In the illustrated embodiment, drape114 is coupled to the skin 118 of the patient. In this exemplaryembodiment, wound insert 112 is coupled to a fluid storage device 120 byconduit 150. Wound treatment apparatus 180 may also comprise negativepressure source 140 configured to apply negative pressure to woundinsert 112 through a conduit 145 or conduit 150 (if the conduit is amulti-lumen conduit as further explained below).

Wound insert 112 may be a foam member, which may be open-celled and/orreticulated. In specific embodiments, the wound insert comprises anopen-celled reticulated foam. An open-celled reticulated foam has anetlike microstructure, with few if any closed cells. In certainembodiments, the porosity can range from 95%-98%, though less porous ormore porous foams may be used.

In certain embodiments, wound insert 112 may comprise a polyurethane,such as polyurethane-polyester or polyurethane-polyether; polyolefins,such as polypropylenes (PP) or polyethylenes (PE); silicone polymers;polyvinylchloride; polyamides; polyesters; acrylics; thermoplasticelastomers such as styrene-butene-styrene (SBS) orstyrene-ethylene-butene-styrene (SEBS); polyether-amide block copolymers(PEBAX); elastomers such as styrene butadiene rubber (SBR); ethylenepropylene rubber (EPR); ethylene propylene diene modified rubber (EPDM);natural rubber (NR); ethylene vinyl acetate (EVA); polyvinyl alcohol(PVOH); polyvinyl acetal; or polyvinyl butyral (PVB). Additionally,wound insert 20 may comprise a bioabsorbable polymer, examples of whichinclude polylactic acid, polylactide (PLA), polyglycolic acid,polyglycolide (PGA), and polycaprolactone (PCL). Methods ofmanufacturing open-celled reticulated foam are well known. Open-celledreticulated foam is commercially available from a variety of sources,including Kinetic Concepts, Inc., San Antonio, Tex., U.S.A.(www.kcil.com).

Wound insert 112 may be of any suitable shape having a depth dimension,including a sheet, a rectangular prism, a cone, a cylinder, a sphere, orany other suitable shape.

In the exemplary embodiment shown, wound treatment apparatus 180comprises a fluid storage device 120 configured to deliver fluid 170through conduit 150 to wound dressing 110. In certain exemplaryembodiments, fluid 170 may comprise medicinal fluids, antibacterialfluids, or irrigation fluids.

In specific exemplary embodiments, conduit 150 may comprise a singlelumen conduit (e.g., switched between a vacuum source and/or a fluidsource) or can comprise multiple single-lumen conduits or a multi-lumenconduit such that, for example, fluid can be delivered and/or negativepressure can be applied to wound dressing 110 individually orsimultaneously. In other exemplary embodiments conduit 150 can comprisemultiple lumens, for example, as in a single conduit with a centrallumen for application of negative pressure and/or fluid delivery and oneor more peripheral lumens disposed adjacent or around the central lumensuch that the peripheral lumens can be coupled to a pressure sensor tosense and/or detect a pressure or negative pressure between drape 114and a wound surface. In the embodiment shown, system 100 furthercomprises a coupling member 160 configured to be coupled to conduit 150.One example of a suitable coupling member 160 is the “V.A.C. T.R.A.C.®Pad,” commercially available from KCI USA, Inc. of San Antonio, Tex.,U.S.A. One example of a suitable drape 114 includes the “V.A.C.® Drape”commercially available from Kinetic Concepts, Inc., San Antonio, Tex.,U.S.A (www.kcil.com). Various wound therapy systems and components arecommercially available through Kinetic Concepts, Inc. and itsaffiliates.

In the embodiment shown in FIG. 2, wound treatment apparatus 180 may beconfigured to deliver instillation fluid to wound 116, to remove fluidfrom wound 116, and to apply negative pressure to wound 116 throughdrape 114 and wound insert 112.

Wound treatment apparatus 180 may be activated to deliver fluid 170 fromfluid storage device 120 to wound 116 through conduit 150 coupled towound insert 112 through coupling member 160. Negative pressure source140 may also be actuated to provide negative pressure to wound 116through drape 114 and wound insert 112.

Example of fluids 170 that may be delivered to wound 116 includehypochlorous acid (HOCl) and hypochlorite ion (ClO⁻, which is alsocommonly referred to, generally understood to be synonymous with, andmay be referred to interchangeably in this disclosure as, OCl⁻), whichare examples of effective antimicrobial agents for biocidal action. Forexample, HOCl is typically capable of killing a broad spectrum ofmicrobes (e.g., fungus, bacteria, viruses, fungus, yeast, and the like);often in a relatively short period of time (e.g., is capable of killinggreater than 99% of microbes within a period of less than 10 seconds).

Such antimicrobial agents can be generated or formed by a combination ofthe present reactive agents and fluid (e.g., water and/or aqueoussolution, such as, for example, saline solution) and may be moreeffective and/or more versatile than antibiotics and other commonly usedantimicrobial agents used in wound treatment in the past. For example,antibiotics may be bacteria-specific such that testing may be requiredto determine a suitable antibiotic to use for a specific wound orinfection; and/or such that antibiotics may have only limitedeffectiveness for individual wounds and/or infections (e.g., wheretesting is not performed and/or where a wound is infected with aplurality of different bacteria).

Such testing may take as long as several days to determine anappropriate antibiotic, delaying treatment or selection of an effectiveantibiotic. Additionally, bacteria may develop resistance toantibiotics, such that antibiotics may have reduced effectiveness afteran amount of time. Further, antibiotics are typically administeredintravenously (systemically) such that antibiotics may kill beneficialbacteria (e.g., in a patient's digestive system) and/or may cause organdamage (e.g., to a patient's liver).

Further, wound treatment apparatus 180 may be configured to remove spentinstillation fluids, secretions, and/or infected tissue from wound 116.Undesirable effluent may be removed by actuating the negative pressuresource 140; effluent may flow into wound insert, through conduit 145,and into a waste chamber coupled to wound treatment apparatus 180.

As previously described, in this exemplary embodiment, fluid 170comprises molecules 175 having a protective coating 176 surrounding anactive agent 177. In certain embodiments, protective coating 176 may beconstructed using a layer-by-layer technique (LbL) where polyallylaminehydrochloride (PAH)/polysodium 4-styrenesulfonate (PSS) may be thelayers used to form coating.

During operation, as fluid 170 is initially transported from fluidstorage device 120 and through conduit 150, protective coating 176surrounds active agent 177 of molecules 175. Upon reaching couplingmember 160, energy source 130 directs energy to fluid 170 and degradesor breaks down protective coating 176. It is understood that in otherembodiments, energy source 130 may direct energy to fluid 150 at otherlocations within wound treatment system 100. For example energy source130 may direct energy to fluid 170 at a location within wound treatmentapparatus 180, along conduit 150, or directly in wound dressing 110.

In certain embodiments, it may be beneficial to have energy source 130direct energy to fluid 170 in a location proximal to wound dressing 110.Such a configuration can allow protective coating 176 to remain in placeas fluid 170 is transported to wound dressing 110. This can minimize theeffects of exposure of fluid 170 to materials or environmentalconditions (e.g., light, temperature, etc.) that may affect active agent177 of fluid 170.

In certain embodiments, energy source 130 may direct ultrasonic,magnetic, radio, ionizing radiation, microwave or light energy to fluid170. In specific embodiments, energy source 130 may direct ultraviolet,infrared or visible light waves to fluid 170. In certain embodiments,energy source 130 may emit light with a wavelength in the range ofapproximately 400 nm-450 nm. In particular embodiments, energy source130 may emit ionizing radiation in the form of gamma rays, x-rays, orelectron-beams.

In particular embodiments, energy source 130 may activate a component offluid 170 that in turn degrades or breaks down protective coating 176.For example, fluid 170 may comprise a component that does not degradeprotective coating under particular temperature or light conditions.However, when energy source 130 directs energy to fluid 170, theenvironmental conditions are changed sufficiently that the componentdegrades protective coating 176. In other embodiments, energy source 130may be configured to directly degrade protective coating 176 without theuse of an additional component in fluid 170.

After protective coating 176 is degraded, active agent 177 can provide atherapeutic benefit to the patient. Non-limiting examples of thetherapeutic benefits that may be provided to a patient includeantibiotic and analgesic properties. Therapeutic properties may also aidwith debridement, improve the ability to remove the wound dressing, andreduce biofilm buildup in the wound.

By protecting active agent 177 in protective coating 176 until fluid 170is proximal to wound dressing 110, it is believed that more accuratedosing of active agent 177 can be achieved. For example, in certainprior art wound treatment systems that do not provide for protection ofan active ingredient, it may be necessary to increase the dosage orconcentrations levels of the active ingredient in a fluid container toaccount for degradation during delivery. Wound treatment system 100 canreduce the amount of degradation of active agent 177 during transport offluid 170 throughout.

The various illustrative embodiments of devices, systems, and methodsdescribed herein are not intended to be limited to the particular formsdisclosed. Rather, they include all modifications and alternativesfalling within the scope of the claims. For example, in certainexemplary embodiments, the protective coating may comprise anultraviolet-activated protective cover which is partially activated tobreak down by ambient light while traveling through the conduit to thewound dressing (or during storage in the fluid storage device). Thebreakdown of the protective coating can then be completed by an energysource proximal to the wound dressing.

In certain exemplary embodiments, rather than a protective coating, thefluid may comprise molecules constructed so that the active agent isinhibited by a light sensitive branch. In such embodiments, for example,exposure to ultraviolet light could be used to break the branch andactivate the compound. Such configurations could be of use with activeagents that have a short active life due to a spontaneous reaction orfrom interaction with the surrounding environment. In particularembodiments, photoinhibition could also be used to control the behaviorof the active agents.

Certain exemplary embodiments may also comprise a clotting agent, e.g.fibrin, chitosan, and trivalent salts, such as Fe⁺⁺⁺ & Al⁺⁺⁺. Inparticular embodiments, a Fe+++ compound (such as ferric chloride) canbe encapsulated in a glucose sensitive microcapsule (e.g.,glutaraldehyde cross-linked hemoglobin and glucose oxidase). Onencountering glucose (which may be present in wound fluid or instilledby the user), the permeability of the microcapsule increases allowingfor the release of the Fe+++ agent. The wound fluid may also enter themicrocapsule and initiate the clotting reaction. In specificembodiments, the clotting agent may be applied to the wound dressing.The clotting agent may be protected by an active layer capable of beingactivated by haemoglobin and releasing the clotting agent locally. Incertain embodiments, the clotting agent is the active agent in amolecule with a protective coating, and may be activated as described inprevious exemplary embodiments.

In particular embodiments, thrombin may be utilized in the clottingmechanism, for example, in combination with fibrinogen. In specificembodiments, thrombin may be inhibited or ‘blocked’ byp-Amidinophenyl-(E)-4-diethylamino-2-hydroxy-alpha-methylcinnamatehydrochloride through covalent bonding. By exposing the blocked thrombinto light (e.g., at approximately 366 nm) the thrombin may unblocked andclotting can occur.

In other exemplary embodiments, the fluid may comprise multiplemolecules, particles or agents in the fluid which are activated bydifferent wavelengths of light or frequencies of energy, which could bedelivered at the point of entry to the wound or once in the wound toactivate them. For example, in certain embodiments a light-activatedgroup (e.g. the thrombin-fibrinogen group described above) could begrafted onto a molecule at one location. At another location on themolecule, a group could be grafted that would liberate cations whenexposed to light at a wavelength other than 366 nm. Non-limitingexamples of such chemical groups that could be used to liberate cationsinclude (photoacid generators [PAGs]) in the 150 nm-350 nm UV lightrange are carboranes, and diphenyliodonium nitrate (activated at about226 nm). A simple alternative, avoiding grafting, would be to mix thetwo sensitive materials (clotting agent and cationic agent). Thecationic agent would be acidic and could aid in debriding

In particular exemplary embodiments, local activation of the energysource may be utilized in the wound by either a coating on the woundinsert local to a targeted issue such as necrotic tissue or by localisedexternal stimulation. In certain exemplary embodiments, multiplemolecules in the wound fluid may be utilized which activate based uponreaction with biomarkers in the wound (e.g., inflammatory responsemarkers).

The claims are not intended to include, and should not be interpreted toinclude, means-plus- or step-plus-function limitations, unless such alimitation is explicitly recited in a given claim using the phrase(s)“means for” or “step for,” respectively.

We claim:
 1. A system for treating a wound, comprising: a fluid storagedevice having a fluid comprising a therapeutic agent; anegative-pressure source configured to draw the fluid from the fluidstorage device through a wound dressing; and an energy source configuredto direct energy to the fluid to activate the therapeutic agent.
 2. Thesystem of claim 1, wherein the therapeutic agent comprises moleculeshaving a protective coating prior to exposure to the energy source. 3.The system of claim 2, wherein the energy source is configured todegrade the protective coating.
 4. The system of claim 2, wherein theenergy source is configured to activate a component of the fluid thatdegrades the protective coating.
 5. The system of claim 1, wherein theenergy source is configured to direct energy to the fluid proximal tothe wound dressing.
 6. A system for treating a wound, comprising: afluid storage device having a fluid comprising a therapeutic agent; asupply pump configured to move the fluid from the fluid storage deviceinto a wound dressing; and an energy source configured to direct energyto the fluid to activate the therapeutic agent.
 7. The system of claim6, wherein the energy source is configured to emit ultrasonic energy. 8.The system of claim 6, wherein the energy source is configured to emitmagnetic energy.
 9. The system of claim 6, wherein the energy source isconfigured to emit radio frequency energy.
 10. The system of claim 6,wherein the energy source is configured to emit ionizing radiationenergy.
 11. The system of claim 6, wherein the energy source isconfigured to emit microwave energy.
 12. A method of treating a wound,the method comprising: applying negative pressure to a wound dressing;drawing fluid through the wound dressing; and directing energy to thefluid proximal to the wound dressing and activating a therapeuticproperty of the fluid.
 13. The method of claim 12, wherein activating atherapeutic property of the fluid comprises degrading a coating of amolecule in the fluid.
 14. The method of claim 12, wherein thetherapeutic property includes an anti-biotic property.
 15. The method ofclaim 12, wherein the therapeutic property includes an analgesicproperty.
 16. The method of claim 12, wherein the therapeutic propertyaids with debridement the wound.
 17. A method of treating a wound, themethod comprising: pumping fluid through a wound dressing; and directingenergy to the fluid proximal to the wound dressing and activating atherapeutic property of the fluid.
 18. The method of claim 17, whereinthe therapeutic property comprises molecules with a protective coatingand activating the therapeutic property comprises degrading theprotective coating.
 19. The method of claim 17, wherein activating atherapeutic property of the fluid further comprises reducing biofilmbuildup.
 20. The method of claim 17, wherein activating a therapeuticproperty further comprises debriding the wound.